<form method="post" action="/application/purchaseOrder"
	class="form-inline">
	<fieldset>
		<span class="label label-info">Shopping Cart</span>
		<div  id="result" class="controls"></div>
		<div class="shoppingcartframe">
			<br><span class="label label-info">Nutrition facts</span>
			<div >
				<a class="btn btn-link" href="#nutritionDetailsModal"
					data-toggle="modal">Nutrition Details</a><img
					id="nutritionDetailsImg" src="/public/img/smiley.png"
					class="img-rounded" height=35 width=35>
			</div>
		</div>
		<div>
			<br><span class="label label-info">Payment*</span> 
			<div>
			<label class="radio">
				<input type="radio" name="paymentMethod" id="cash" value="cash"
				onchange="$('#ccInfo').css('display','none');" checked> Cash
		<br></label> <label class="radio"> <input type="radio"
				name="paymentMethod" id="creditCard" value="creditCard"
				onchange="$('#ccInfo').css('display','inline');"> Credit card
			<br></label>
			</div>
		</div>
		<div id="ccInfo" class="controls controls-row" style="display: none">
			<input type="text" class="span2" placeholder="Credit card no.*"
				name="creditCardNo" /> <input type="text" class="span1"
				placeholder="CVV2*" name="validationNo" />
		</div>
		<br><span class="label label-info">Delivery information</span>
		<div class="controls">
			<label class="radio inline"> <input type="radio"
				name="delivery" value="pickup" id="pickupDelivery"
				onchange="showDiscount();">Pickup (10% off)
			<br></label> <label class="radio inline"> <input type="radio"
				name="delivery" value="delivery" checked onchange="hideDiscount();">
				Delivery
			<br></label> <input class="span3" type="text" placeholder="Company name"
				value="${user?.shippingInformation?.companyName}"> <label
				class="radio inline"> <input type="radio" name="isMale"
				value="true" checked> Mr.
			</label> <label class="radio inline"> <input type="radio"
				name="isMale" value="false">Ms.
			</label>
			<div>
				<div class="controls">
					<input class="span3" type="text" placeholder="First name*"
						name="firstName" value="${user?.firstName}"> <input
						class="span3" type="text" placeholder="Last name*" name="lastName"
						value="${user?.lastName}">
				</div>
				<div class="controls controls-row">
					<input class="span2" type="text" placeholder="Street**"
						name="street" value="${user?.shippingInformation?.street}">
					<input class="span1" type="text" placeholder="No.**"
						name="streetNo" value="${user?.shippingInformation?.streetNo}">
				</div>
				<div class="controls controls-row">
					<input class="span1" type="text" placeholder="Code**"
						name="postalCode" value="${user?.shippingInformation?.postalCode}">
					<input class="span2" type="text" placeholder="City**" name="city"
						value="${user?.shippingInformation?.city}">
				</div>
				<input class="span3" type="text" placeholder="Phone*" name="phone"
					value="${user?.shippingInformation?.phone}"> <input
					class="span3" type="text" placeholder="E-mail*" name="email"
					value="${user?.email}">
			</div>
			<div>
				<h6>* Mandatory fields</h6>
				<h6>** Mandatory fields if delivery</h6>
			</div>
		</div>	
	</fieldset>
</form>

